My Lovely Wife in the Psych Ward

My Lovely Wife in the Psych Ward

Feb 4, 2014 - One of my dear friends from college sent me a link to The Moth podcast on which Mark Lukach told his story about supporting his wife through her struggle with mental illness. On May 2, 2017 Mark published his first book, My Lovely Wife in the Psych Ward

Two weeks after my friend Jen sent me the link to Mark's story, we were on vacation in Florida for my grandmother's 90th birthday. I sat my family down - Ben, my mom and my dad - around the kitchen table to listen together. Tears flowed. Giulia's story had so many parallels to my own. I was so moved and impressed by how her husband could articulate what he had went through as he watched her struggle with her illness, helpless at times but he never gave up on getting her well.

In reading Mark's book, I had a glimpse of what my family and husband must have gone through during the early stages of my illness. The research, navigating the system, figuring out how to best support me as I called my parents sobbing every day for a year. Actually, their response to my depression seemed intuitive. Both my parents were so supportive and patient with me as I struggled to understand what was happening to me. My mom and I are similar in our typical impatience with nearly everything, but this was different. It must have hurt them to see me in such pain. 

This was brought to light in Mark's storytelling. He was able to so eloquently take the reader into the thoughts and emotions running through his mind as he watched his wife lose hers. I often think about how terrifying it must have been for Ben and my family to see me lose control of my thinking. To this day Ben has a hard time talking about it.

My guess is this book was as therapeutic and healing for Mark to write as participating in This Is My Brave has been to me and my storytellers. Each time we are able to unpack those complicated memories from our experiences with mental illness, we relieve the burden of holding onto those heavy secrets. 

Loving someone who lives with a mental health issue is definitely not easy. But I don't think a person has ultimate control over who they fall in love with. And with the statistics on the number of people living with mental health issues, chances are high most relationships face these challenges. In our case, and in Mark and Giulia's, the journey only made us stronger. It changed my relationship with Ben for the better and I wouldn't change a thing. My guess is Mark and Giulia wouldn't either.

To order My Lovely Wife in the Psych Ward, use our This Is My Brave Amazon Smile link and we'll earn a tiny donation. {I had pre-ordered the book and was lucky to receive this beautiful coloring page from Mark and Giulia's son Jonas when it shipped in February. Been meaning to write this review ever since.}

Fun side note: Since connecting with Mark and Giulia on Twitter a few years ago, we're hoping to meet in person this summer since Mark's family still owns a beach house at Bethany Beach and my parents just bought one. It's neat when internet friends meet up in person. Today is also Mark's Birthday! Happy Birthday, Mark!

8 Things I Want People To Know about Postpartum Psychosis

8 Things Postpartum Psychosis  

I love all the media attention these past few weeks on postpartum depression. It’s so important for us to keep these conversations going so that more women and families understand that they are not alone and that it’s okay to reach out for help because treatment works. It’s wonderful to see celebrities like Hayden Panettiere, Drew Barrymore, and Alanis Morissette opening up about their stories because when people we admire, women we assume have it all together, open up and show us their struggles, we pay attention.

I’m just a mom, with a 5-year old little man, who wants to prove to the world that our struggles don’t define us. They only provide us with opportunities to make a difference in the world. I’m beginning to work on explaining this to him every chance I get.

- from a post I wrote dated Sept 19, 2013

We also need to be talking about postpartum psychosis. I was diagnosed with PPP a month after my first child was born, and suffered from antenatal psychosis (psychosis during pregnancy) during my second pregnancy. Both times I had been avoiding my medication for bipolar disorder because I didn’t want to expose the baby to the risks.

I want to share what I’ve learned. Maybe then, more people will understand postpartum psychosis the way they’re beginning to understand PPD, and the women and families who experience it will feel as supported as those who go through postpartum depression.

      1. Women who experience PPP are NOT monsters. Yes, it’s true that untreated PPP can lead to infanticide, but that doesn’t mean it’s the mother’s fault. She was sick and needed treatment, and the more we’re able to identify the symptoms and the sooner she’s able to get treatment, the chances of her actually harming her baby can be avoided all together.
      2. We can be good at hiding the onset of PPP. Having been diagnosed with bipolar disorder two years before I had my first child, I knew what the beginning of a manic episode felt like. I was euphoric, energized despite the severe lack of sleep, and highly social, planning playdates when obviously I should have instead been resting. I hid my initial symptoms for fear of having my son taken from me. I was terrified of failing as a mom.
      3. Family and spouses/partners are usually the first to know something is wrong. If it weren't for my husband, who knows what could have happened. The morning my husband called 911 to have me hospitalized, I woke at 5am after having barely slept the night before due to the baby’s feeding schedule and my extreme mania. I was in the kitchen rearranging the items in our cabinets. My speech was pressured (had so many things to tell my husband but the words wouldn't come out fast enough), and what I was able to verbalize wasn't making any sense. He recognized these symptoms from my two previous manic episodes years before, combined with how little sleep I was getting, and immediately called 911.
      4. Sometimes the woman can’t even see how badly she needs help. Seeking help for psychosis symptoms is very different than seeking help for postpartum depression. Usually it is not the woman herself who seeks treatment, but the spouse/partner or family member who initiates treatment through hospitalization. After the birth of my first and during my second pregnancy, I became so ill that I couldn’t realize exactly how far gone I was. It was a gradual process, but once I reached a certain level of mania, the chaos in my brain took over and catapulted me into psychosis and it was up to those around me to find a way to bring me back. Involuntary commitment was what I needed both times.
      5. It can be difficult to admit symptoms. Some women have thoughts of harming their children, and some of them act on those violent thoughts. Stories like the one of Andrea Yates might make women afraid of reaching out for help for fear of being looked down upon by friends or family members. I was one of the lucky ones who didn’t have those intrusive thoughts, but it was still incredibly difficult for me to admit that I needed help.
      6. Although rare, there are predicting factors, and PPP can be prevented. Postpartum psychosis is much less common than postpartum depression. Although there are underlying conditions which can predispose a woman to developing postpartum psychosis, a diagnosis of bipolar disorder being the main factor, any pregnant woman is potentially at risk. Which is why we need to raise awareness around PPP the same way we are raising awareness around PPD.
      7. Breastfeeding isn’t the only way to feed a newborn. I put tremendous pressure on myself to breastfeed my first child. “Breast is best” was everywhere I turned during my pregnancy and I correlated my ability to feed my child from my body with how successful I was as a new mom. Not only was this wrong, it was incredibly unhealthy. With my second child, we had a plan to bottle-fed with formula from the start, which led to a much more enjoyable postpartum period as compared to my first month of new motherhood breastfeeding my son.
      8. Moms who experience PPP are good moms, too. If I would have known that experiencing this illness was not my fault, and that there were other moms out there who also had to be hospitalized following the births of their babies, it would have been a little easier. Which is why I share my story. If even just one person finds my story and she’s able to get help sooner rather than later, it’s all worth it.

We Need Universal Mental Health Screening for Women Having Babies

we-need-universal-mental-health-screening I experienced both a postpartum mood disorder (postpartum psychosis) and a perinatal psychiatric issue (a manic episode which led to psychosis) very early on in my second pregnancy. I had been diagnosed with Bipolar Disorder two years before my husband and I decided to start a family, and yet I found limited support and information in my quest to have as healthy a pregnancy and postpartum experience as I could. When I think back to that time in my life, I strongly believe that if I had received better screening - particularly after my first pregnancy - much of the trauma and heartache of what I went through could have been avoided.

Before I experienced mental illness on a personal level, my ignorance of the various forms of psychiatric conditions caused me to judge people whose stories were covered in the media. I remember watching news coverage of the Andrea Yates trial thinking HOW COULD THAT HAPPEN? And then it happened to me seven years later. Thank God my outcome was drastically different.

Just this week a pregnant mother and her three children were rescued in Daytona Beach, after she drove the family minivan into the ocean. A family member had called police hours earlier to express concern over her strange behavior, including talk of demons.  On the 911 tapes, you can hear the sister request a well-being check because "she's like having psychosis or something."

This woman literally saved her sister's life, the lives of those three children and the life of her sister's unborn baby with that call for help.

They were lucky to have avoided an outcome similar to that of the Andrea Yates case. Simply because someone close to the person who was suffering took action.

Now it's our turn to take action. There is an urgent need for changes in the way we screen women during pregnancy and postpartum in order to stop incidents like these from ever occurring in the first place.

Maybe this woman's sister recognized what her family member was going through because of the increase of more open dialogue about women's mental health issues. I can feel the wave of mental health awareness gaining momentum and hope that very soon there will be less ignorance out there and more acceptance. Because together we can make a difference.

Which is why I support this important White House petition to create mandatory universal mental health screening for pregnant and postpartum women. Did you know that suicide is the leading cause of death for women during the first year after childbirth? Or that 1 in 7 women will experience a mood or anxiety disorder during pregnancy or postpartum, yet nearly 50% remain untreated?

We need change. We need to screen every mother, every time to prevent and treat perinatal mental illness.

Recovery is possible - I am a perfect example of this. But wouldn't it be incredible if in the future we could catch cases like mine before they escalate? Before they lead to suffering and even death? No woman should have to suffer in silence because she's afraid to admit what she's thinking or feeling. We need to provide her with the chance to find recovery early. We need to recognize the signs and symptoms and take action.

Please take a moment to sign the petition: Every Mother, Every Time. Creating a WhiteHouse.gov account takes only a minute and there are simple tools to share the petition on Facebook and Twitter once you have submitted your signature.

This movement will save lives. We need 100,000 signatures to get the attention of the Obama Administration. Let's come together to make our voices heard on this critically important issue.

Every Mother, Every Time.

Tweet about the petition with the hashtag #EMET:

[Tweet "Universal mental health screening 4 every pregnant & postpartum woman http://ow.ly/uho8X. #EMET"]

Thank you for helping to spread the word.

My {In}voluntary Commitment and Why You Should Care

3503612082_da5ca41899Photo Credit: yyellowbird via Compfight cc

Our bedroom door creaked slowly open at 6:35am this morning and my little man crawled under the covers next to me while my husband finished getting dressed for work. As I felt the chill of little toes brush my warm legs, I thought back to this same day, five years ago, when my mania had reached the breaking point.

I had begun to cross the threshold, going from highly manic to the inevitable psychosis, when my husband took matters into his own hands and called 911 for help.

What a stark comparison to today, I thought, as I reached into my sock drawer to fish out my psych ward socks. I pulled them on this morning as a way of honoring my past, while at the same time recognizing how far I’ve come and how I don’t ever want to go back.

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If your father were having a heart attack, or symptoms consistent with those of a heart attack, you would rush him to the hospital where he would receive treatment. If your child had a 104 fever and was gravely ill but refused to take any medicine, you would call your pediatrician who would tell you to rush the child to the Emergency Room where he would receive medical assistance.

But if someone you loved were experiencing a mental health crisis and needed to see a psychiatrist or be involuntarily committed to a psychiatric facility to receive treatment, you wouldn’t believe the obstacles you have to surpass in order to get them the care they need to get well.

I know, because my family and I plunged head first into these roadblocks in the U.S. mental healthcare system five years ago when I was hospitalized for postpartum psychosis after the birth of my first child in 2008. Writing about this experience was something I wanted to do in order to educate people about the policies surrounding access to mental health care in the state of Virginia. {The laws vary by state. A good resource with links to studies and comprehensive information is MentalIllnessPolicy.org.}

In researching my mental illness and the treatment I received during my hospitalization, I requested copies my medical records from the hospital. I’d like to take you back to the week of October 22nd, 2008, approximately four weeks after I had given birth to my son. Belly still swollen, breasts leaking milk, I lost touch with reality during the early hours of that cool fall morning, but remained silent about my growing sense that this would be my last day on earth.

I was terrified of being taken away from my baby even though there was a little voice in the far corner of my mind urging me to go. I just didn’t want to listen.

That morning my husband knew from my past two manic episodes that I needed to be taken to the hospital. He called his mom and sister to come over and help, as we had been through this before and he knew my erratic manic behavior would require more than one person assisting in the effort to get me ready to be transferred. His next call was to dial 911, where he explained to the dispatcher that I had a bipolar diagnosis, was off my meds because of having just had a baby, and was now rapidly deteriorating and we were in need of help to get me to the hospital. He then called my psychiatrist, leaving her a message to tell her what was going on. And lastly he called my parents in Florida to alert them as well.

I remember being on the phone with my Dad while sitting on a chair in the kitchen, talking to him on speaker phone while the two female police officers who had been dispatched to our house were standing right before me. He was pleading with me to go with them. I don’t recall much, other than being afraid. I don’t know exactly how much time passed, but eventually they were able to take me, in handcuffs, under a Temporary Detention Order (TDO), to our local hospital for an evaluation.

I was clearly manic to the point of psychotic. It was well documented in the detention order paperwork that I had reported hearing voices and seeing ghosts in the baby’s room. My husband had told the officers that I had only slept 3-4 hours a night for the four nights leading up to his call for help. His sleep estimates were correct - it had been the weekend of our son’s baptism and I was trying to prepare for out-of-town guests along with getting everything ready for the party we were hosting. On top of learning to care for our new baby and suppressing the mania that I had felt since the night he had been born, it all caught up to me.

The Temporary Detention Order allowed my husband to have me sent to the hospital for an assessment. My husband was my Petitioner - the person asking that I be involuntarily committed. We were led to an empty hospital room where I was handcuffed to the metal bars of the hospital bed. My husband stayed by my side the entire time. The nurses assessed me and it was determined that there was substantial likelihood that, as a result of my mental illness, in the near future I would suffer serious harm due to a lack of capacity to protect myself from harm. I refused all meds in the Emergency room and I met the criteria for involuntary admission to a psychiatric ward of the hospital, not to exceed a 30-day stay.

I was taken by police car, still handcuffed, to our local hospital’s geriatric psychiatric ward, the nearest facility with a bed available. By the time the bed had become available, it was late at night and I remember being terrified upon entering the facility because of the Halloween decorations festively decorating the glass doors which were pulled open for me. My throat closed and I struggled to breathe, leaning all my weight back, attempting to keep them from guiding me in. They eventually coaxed me in and a young attendant began working with me to get me through the intake process. I remember her arms, covered with tattoos. Her name was Jenny.

They tried to give me drugs to force me to sleep, but my mania was so rampant and I continued to refuse oral medication, so I was given an injection to tranquilize me and my body succumbed to the rest it so desperately needed. I woke groggy, and still very ill.

The Temporary Detention Order meant I could be held involuntarily for one to five days, until a commitment hearing could be held. I was admitted the night of October 22nd, and my commitment hearing was scheduled for 9am on the 24th.

After only thirty-six hours of psychiatric care, I was still extremely sick and my mania was apparent to everyone close to me. But the chemical imbalance that was still working itself back to balanced with the help of the meds and forced rest, wasn’t severe enough to present me as a threat to myself or others during the trial, and despite my family’s strong arguments that I was not well enough to go home and care for myself, let alone a newborn, the judge still deemed me well enough to not be held against my will.

I was free to go home. Case dismissed.

My father spoke with the judge immediately following the trial’s conclusion. He was shocked and couldn’t believe the judge was going to send me home in the condition I was in. My father then asked if they (my family) were able to convince me to stay in the hospital, voluntarily, would I be able to stay?

The judge informed him that yes, I would of course be able to stay on a voluntary basis, but on the same token, I’d be able to sign myself out at any time.

This news was plenty good enough for my family and they immediately began encouraging me to stay and rest, so that I’d be able to return to my newborn baby in a much clearer state of mind. They knew that with just a few more days of treatment and solid sleep, I’d be in a significantly better place to where I could continue to see my outside psychiatrist and work on making a full recovery.

Fortunately, I was well enough to rationalize their concern for me and that was all it took to convince me to sign myself in. I stayed for three more days. My husband and dad came to visit me every day to check on my progress. They used my somewhat still disoriented state to their advantage as they were able to remind me each day that “we all needed to be in agreement that it was the right time for me to go home,” and I was too fragile mentally to process what had happened in the hearing so I followed their lead. I had signed myself in to stay and could leave when I was ready, but I didn’t really comprehend it all at the time.

I called home daily to check on my baby and asked them to bring pictures to the hospital. He changed so much in that week that I missed. His wispy brown hair on top fell out, so he had a bald head with only hair on the sides and around to the back. I cried at a picture they brought me of him smiling on his back laying on a blue and green striped baby blanket. Desperate to get back to my son, I eagerly took my meds each day and night, and did my best to be a model patient.

I signed myself out of the hospital on the 27th, after a 5-day stay, and walked into the kitchen of my house where my mom was stirring a pot of homemade chicken noodle soup cooking on the stove. I made my son a bottle of formula and sat on the couch to learn the art of bottle feeding him after having spent a month perfecting breastfeeding. I will never forget that moment. While feeding him and gazing into his eyes I silently vowed that I would do everything in my power to stay healthy for him. I never wanted to be taken away from him again.

Some people might say that involuntary commitment laws take away a person’s constitutional right to freedom. I completely disagree.

My family sought help for me because they knew I was so severely ill. The system initially determined I was a threat to myself, but the judge at the commitment hearing determined that was no longer the case. Situations like this happen all the time due to the current state of our mental health system and unfortunately, these holes in the system are what contribute to tragedies like Virginia Tech, Sandy Hook or the Navy Yard shootings. It’s the subjective “threat to themselves or others” which is determined by someone who has never met the mentally ill person, which is what needs to change.

People who are aware of family or friends who have mental health issues (and we all know someone given the statistic of 1 in 4 Americans living with a mental illness) need to be more proactive when they sense a change in someone’s behavior. By paying attention to the fragile mental states of people within our own environments, we will be able to push for help before it’s too late. The mental health laws need to be reviewed and modified to permit family and friends to have the ability to have people in trouble involuntarily committed for longer periods of time, so they are better able to make bigger strides towards recovery during the time in which they are under the hospital's psychiatric care. Until this done, we will continue to see more tragedies.

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On this fifth anniversary of my TDO and subsequent voluntary psychiatric commitment, I’m able to smile at my son’s insistence on dressing up as a ghost for Halloween. Five years ago I was not taking my medication and therefore went through hell, reportedly saw ghosts, and thought the world was coming to an end. But today I’m cutting eye holes out of a white sheet to dress my little man up on the last day of this month. A costume which serves as a gentle reminder of my past, while allowing me to appreciate the invisible challenges which inevitably lie ahead.

Brave Because I Want To See Society Change

I learned of yesterday’s shooting here in Washington, DC, via the news pouring into my Twitter feed about the woman who had crashed her car into the gate surrounding the White House. There was speculation that a child was in the car with her at the time. There was also speculation that she suffered from mental illness.

Then she was shot by police and died soon after. The baby, thankfully, was unharmed in the ordeal and is now in the custody of child protective services.

I am so utterly heartbroken for this woman, her child, her family and friends and our society.

This needs to stop.

But unfortunately, until our country stops blaming people with mental illness for their conditions and starts providing the mental health services they need to get well, incidents like what happened yesterday will continue to occur.

We need to come together as a society to talk openly about mental health issues. If you notice someone exhibiting the signs and symptoms of a mental illness, do what you can to help them get the treatment they need. I guarantee you they are too sick to realize they need help.

We need to stop hiding our mental illnesses, because by hiding we are adding to the stigma.

Earlier this year I made the choice to go public with the fact that I live with Type 1 Bipolar Disorder. That I’ve been hospitalized a total of four times for mania, once was postpartum psychosis after the birth of my first child in 2008. That I once was afraid and ashamed to speak openly about my illness.

Today, I am neither afraid nor ashamed of my illness. I am proud to talk openly about my experiences because my openness helps others. They've told me so.

When we come together to share our stories, we propel a movement forward. A movement to shift the way people view the mentally ill. A movement to bring desperately needed changes to the state of mental health services in our country. A movement to stop the loss of innocent lives - both the mentally ill themselves and the people they harm when they are sick.

You see, yesterday’s news could have been me. I suffer from mental illness. But unlike Miriam Carey, I received proper treatment.

And with proper diagnosis and continuous treatment, people with mental illness can lead perfectly productive lives. They can be {and ARE} valuable members of society when they have the support and services they need to get well and stay well.

I don’t like to think about what could have happened if my husband hadn’t reached out for help. But the reality is that whenever a story like this hits the news and the person involved is thought to have “a history of mental illness,” I am brought right back to the torment and the excruciating emotional pain of what we went through as a family the times I was sick.

We need to change the public's misconceptions about mental illness because when people get treatment, lives can be saved.

I recently wrote a manifesto on my experience living with bipolar disorder. It's called Find Your Brave and I hope you'll take a moment to download it here and share. It's part of my effort to encourage people to stop hiding and seek support because we're so much stronger when we come together.

Let’s come together and show the world This Is My Brave.

Brave-Because-I-Want-Society-To-Change

What I Want You To Know About Postpartum Psychosis

OwenBirthAnnoun

Five years ago today my little man was born.

As for any first-time mom, the excitement and energy of the rush to the hospital to meet him is a bit of a blur, especially given the five years that have flooded my memory since then. Sure, we had the same fears and concerns as any new parents: is he sleeping and eating enough? Are we using the right baby products? When will his umbilical cord heal? Are we doing enough tummy time? But for us, the beginning of our story is quite different than that of most new families starting out.

Because right after he turned four weeks old, I had to be hospitalized for postpartum psychosis.

I knew I was experiencing hypomania from the time that he was placed in my arms around four a.m. the morning after he was born. He tried nursing for the first time and the physical exhaustion and emotional release of having just given birth started to set in. We sent him to the nursery so that I could try to catch up on sleep, but with the nurses checking my vitals every hour due to the C-section, sleep was nearly impossible.

Some people may wonder why I hid my symptoms from the people who could help me. The doctors and nurses who saw me when they came to check on the baby while we were still in the hospital never noticed that I was struggling. My therapist, who saw me when I was three weeks post-partum didn’t detect anything unusual. My husband and my parents could sense something was different about me, but we were all so caught up in the new baby that we pushed my mental health issues to the side and put the needs of the baby first.

I love my son with everything in me, but I know from all that I’ve been through over the past eight years living with bipolar disorder that I need to put my mental health first in order to be the best mother I can for him and his sister.

But in the first few weeks of his life, I didn’t know this. I was just a new mom. Trying my hardest to not screw up. And at the time I thought that meant staying off medication to protect my baby.

I was absolutely determined to breastfeed him. I put so much pressure on myself to make it work that the first week I was barely producing any milk because I was so stressed out and the internal fear that my body wasn’t going to be able to actually make food for my baby was doing just that: stunting my ability to lactate.

We did finally figure the whole breastfeeding thing out, me and Owen. And I nursed him for the first four weeks until I was no longer able to hide the fact that I was losing touch with reality.

I felt as though I was invincible and hardly needed to eat or sleep. The less I slept, the more energy I seemed to have. I never napped when the baby napped because I’d always find something to do around the house that was of course more important than catching up on sleep.

Everything around me had a certain sparkle to it. It was as if I were living in a dream world where everything was amplified and so vivid that I had to stay awake to soak it all in. There was no pain, only the soothing sounds of my baby cooing or crying softly before I picked him up.

It was all very surreal. But when hypomania turns into mania, and mania escalates to psychosis, things can go very wrong.

I am so thankful that my husband realized what was happening and knew exactly what to do in order to fix me.

As hard as it was for him to call 911 and have the police and EMT’s take me to the hospital, he knew that I needed to be separated from my baby for a week in order to get well.

And as much as I mourn the week that I lost with my son, I’m grateful for what I learned and how sharing my story has the potential to help other moms and families out there.

Not enough is shared about postpartum psychosis. Even though it is not nearly as common as postpartum depression, doctors still should discuss the potential chances of the occurrence, specifically in patients like me who had a previous bipolar disorder diagnosis.  Society doesn’t understand it and therefore, families aren’t on the lookout for symptoms in new moms. And I’d like to change that.

Women who experience postpartum psychosis are just normal moms who unfortunately have a chemical imbalance in their brains. Some of these women have thoughts of harming their children, and some of them act on those violent thoughts. I was one of the lucky ones who didn't have those intrusive thoughts, but even if I did - that doesn't make me a monster, as my friend Robin wrote on her blog recently.

I’m just a mom, with a 5-year old little man, who wants to prove to the world that our struggles don’t define us. They only provide us with opportunities to make a difference in the world. I’m beginning to work on explaining this to him every chance I get.

I’m loving watching my son grow into a smart, funny, caring, determined and stubborn little guy who has stolen my heart with his hugs and his smile. I’m still in complete awe of the fact that he grew inside of my belly, remembering the pressure of his little feet apparent from the outside. Bringing him into our lives was a miracle and we couldn’t imagine life any other way.

The other day I asked him what he thought it would feel like to turn five. “I’ll be all grown up! A big kid!” was his response. So much like me, he’s eager to make his way in the world, try new things and move mountains. I’m trying my best to just let him be little, to enjoy the carefree afternoons at the playground or the library. To linger over snacktime at home with him while his sister is still napping. And to savor every small moment we have together like our morning hugs and bedtime stories.

Five years have gone by so quickly but I’m not sad about them passing. The collection of countless precious memories which I’ve tattooed onto the inside of my mind are what I carry with me in my heart from the past.

I’m eager to see what the years ahead hold. Both for him, and for his mom who will always be looking on with pride.

 

Maternal Mental Health Month

Courage_BML

In May 2011, Postpartum Support International (PSI) declared May as Maternal Mental Health Awareness Month. Over the past few weeks I've been busy writing some pieces in support of the efforts to raise awareness of women's mental health before, during and after pregnancy. Two were published recently and I'm proud to share them with you.

 

Yesterday was the 5th annual Mother's Day Rally for Moms' Mental Health, hosted by Postpartum Progress, the most widely-read blog in the world on postpartum depression and other mental illnesses related to pregnancy and childbirth. It featured 24 letters (one of them was mine!) from survivors of PPD, postpartum anxiety, postpartum OCD, depression after weaning and/or postpartum psychosis. Their purpose is to inform and encourage pregnant and new moms who may be struggling with their emotional health. I was honored to be included again this year.

 

Along those same lines of postpartum and mental health, today a piece I wrote for WhatToExpect.com’s Word of Mom blog went live. (Yes, that’s really me in the picture included in the post!) In it I describe the feelings of guilt and sadness I experienced when I had to quit breastfeeding because I needed to return to my medication. I've learned that no mom should put unnecessary pressure on herself to breastfeed, especially if her mental health is at risk.

I hope you have a chance to check out these posts and please share if you know someone who might benefit from the information within. Thanks so much and I hope all those moms out there had a great Mother's Day yesterday!

Dear New Mama ~ don't ignore PPP symptoms. Please.

Dear New Mama, My son was four weeks old and I was manic out of my mind in October of 2008. I was somehow able to hide it so well from everyone close to me, my parents, my best friend, my therapist, even my husband. No one knew but me. But who was I kidding? I couldn’t go on like this, and I knew it. The week after he was born I had broken down crying to my mom, handing her my cell phone pleading with her to call my OB to ask her what I could take to help me sleep. I had been off all medication (except pain meds from the C-section) since October of 2007. A full year with no medication at all: a recipe for disaster for anyone diagnosed as having bipolar disorder two years prior. But I was doing it for the baby. My husband and I both wanted a medication-free pregnancy, and then I wanted to breastfeed and did not want to expose the baby to medications that would come through in the breastmilk.

The first month, I had slept maybe 2-4 hours a night and it was catching up with me fast. I'd take two Tylenol PM and would get a few hours of sleep, but woke up, as I usually did since the baby was born, in a sweaty panic – I just knew he needed to be fed even though he was usually sound asleep at the time. I was trying desperately to make breastfeeding work, but we were struggling. He had lost weight since we left the hospital and the pediatrician forced us to supplement with formula but I was determined. I was so afraid of failing. My best friend was my cheerleader, urging me to keep going, visiting when she could to offer helpful tips and encouragement. My husband was also supportive and we knew it was risky being off medication in order to breastfeed, but we had decided to try it. My parents had arrived two days after the baby was born and were planning on staying a week before heading back down to Florida. When they realized how little sleep I was getting, they were worried and my mom pushed out her return trip by five days. After nearly two weeks of help from my parents, my husband’s parents, friends cooking dinners for us, and my husband being off from work, I had to learn to do it on my own. It is so foggy, those first four weeks, but we took pictures so I could remember. I did it on my own for two weeks, three days. Then the shit hit the fan.

The statistic was 1 out of 1,000. I never thought I'd be that one person who was dealt the postpartum psychosis card. I mean, what are the chances, right? But I guess I really should have seen it coming, having been diagnosed with bipolar disorder only two years earlier.

So, you may be wondering, how did I know that I was experiencing postpartum psychosis? Well, at the moment I didn't. I just knew that how I was feeling couldn't be right.

I was dead-set on breastfeeding, and therefore, was the sole source of milk for the baby so I had to be up every two to three hours. The process of changing his diaper, changing his outfit if he had leaked, swaddling him back up, feeding him on the boob, burping him, and settling him back down took me about forty-five minutes each time. Therefore, I had an hour or so to try to sleep before he would wake again, but instead of sleeping, despite what should have been my intense exhaustion, I would rush around the house doing laundry or dishes or I'd pump to try to get my body to produce more milk so that I could store it. It was as if my body had surpassed the exhaustion phase, and I was now invincible. I was starting to believe that I didn't even need sleep. I also felt super smart - like my brain was functioning at a superior level. Having never been a stellar student in any stage of my schooling, it was weird, to say the least.

During the fourth week, before I was eventually hospitalized, I started experiencing hallucinations. Mostly things are fuzzy, but one I can actually remember is from the morning that my husband finally realized he needed to commit me. I had woken up several times during the night but just stayed in bed listening to the sounds of trucks driving along the highway not too far from our house, hoping to fall back asleep. When the dawn broke and light started filtering in through the mini blinds, the alien spaceship that was hanging from the center of our bedroom (aka: the ceiling fan) began to spin, illuminate, and hover towards me. I shook with fear. But kept my mouth shut. I didn’t want my husband sending me to the hospital. I had to keep feeding my baby. We had just started to “get it” and he was doing well. I was actually enjoying the bonding time it created between me and the baby.

THANK GOD my husband got help. He had to call 911 because he wasn't able to get me to agree to go in the car to the hospital, let alone take medication. I was so lucky, because he knew the signs to look for from my two previous manic episodes, and he wasn't afraid (or too proud) to admit that I needed medical attention. Specifically, anti-psychotics. Stat. And although I never had thoughts of wanting to harm my baby, who knows if those could have been the next thoughts to enter my mind had we waited any longer to get help.

What I want you to know, mama, is that if you ever experience symptoms similar to mine after the birth of your baby, please don't feel ashamed about it. Don't ignore the signs. Have your husband or partner read about them too, so they can be as prepared as you are. Knowing what you know now about postpartum psychosis is half the battle. The other half is being open to accepting the help you need to get better for you so that you can be there for your baby. I did, and I'm so thankful because it was the best decision my husband and I did for our family, and continue to do, each and every day.

The medication I take keeps me "in the middle", as we in my family like to refer to it. I ended up taking it, under the close supervision of both my psychiatrist, OB-GYN, and high-risk OB-GYN, during my second pregnancy and we were blessed with a precious baby girl who has completed our family. I continue to take my medication, see my psychiatrist and therapist regularly, and lean on the support of my husband, parents, and close friends in order to keep my mental health in check.

I wish you all the happiness in the world as you meet your new little bundle of joy. I know that you'll turn out to be one incredible mama. Just like I did.

Much love,

Jennifer aka BipolarMomLife

The 4th Annual Mother’s Day Rally for Moms’ Mental Health is presented by Postpartum Progress, a national nonprofit 501c3 that raises awareness & advocates for more and better services for women who have postpartum depression and all other mental illnesses related to pregnancy and childbirth. Please consider making a donation today, on Mother’s Day, to help us continue to spread the word and support the mental health of new mothers.

Can friends double as therapists?

I find myself wondering why my condition is so difficult for people to talk about. I am someone who wears my emotions on my sleeve, and when I feel a need to talk about what I'm thinking or what I've gone through in the past regarding my bipolar diagnosis, it's sad to me that I usually feel completely alone. My husband is of course always here and will listen whenever I need a shoulder to cry on. And I do feel as though my support system is strong. But sometimes I wish that more of my girlfriends would show an interest in what I have been living with these past six years. It almost feels like a dirty little secret. Except it's not dirty, and it's not even much of a secret anymore. I guess that people are just uncomfortable discussing mental illness. And that makes me sad. What got me started thinking about it was my drive home this weekend. My high school girlfriends and I had planned a girls' weekend to catch up and unwind without the stress of having to chase around toddlers, change diapers, and do naps, baths and bedtimes. (Our husbands graciously all agreed to our request for some R&R and amazingly we were able to find a weekend that worked for everyone.) Except the weather decided not to cooperate and instead of the beach for four days of sun, sand and cocktails, we were forced to choose a different location. One of the girls had just sold her house, and she was in the process of moving out so we gathered some air mattresses and crashed there for three days while Hurricane Irene wrecked havoc all up and down the East Coast. Luckily for us it was not much more than a bad thunderstorm with heavy winds by the time it got to our area.

I guess a part of me was hoping that at some point over the weekend I'd get a chance to talk with everyone about my hospitalizations, my recoveries, and my hope that I can somehow change the public's perception of bipolar disorder and postpartum psychosis by telling my story and the lessons I've learned. But our conversations seemed to revolve more around our kids, work, and family life in general. Don't get me wrong, I had so much fun getting to catch up and spend time with some of my friends who I have known for the longest time. The memories we made this weekend were priceless. I should probably get back to seeing my therapist regularly again instead of trying to turn one of my friends into my own personal Carl Jung. It's on my to-do list for tomorrow morning.

Postpartum psychosis - how it happened to me (Part I)

I was online this afternoon and came across a story in our local online newspaper about a woman who had experienced postpartum psychosis after the birth of her second child. She stopped her car in the middle of DC afternoon rush hour traffic, took off all her clothes, and was running along the shoulder of the road towards a bridge over the Potomac River. She was convinced that she needed to be baptized in the water because the world was ending. The details of her story are eerily familiar to me. I feel for her that she had to go through something as embarrassing as stripping down naked in public. Could you imagine?

But at the same time I am so incredibly proud of her for standing up and telling her story - publicly. She is a brave woman and I truly respect her. She is not afraid of speaking out about this rare disorder that affects only one to two women out of 1,000. It doesn't sound like many at all, but when you do the math, that computes out to 4,100 to 8,200 women in a year based on the average number of annual births.

I think it's about time that PPP gets a voice. There is so much information out there about postpartum depression, but if you ask anyone if they know anything about postpartum psychosis, I would venture to bet that they'd bring up Andrea Yates, the Texas mother who killed her five young children by drowning them in the bathtub in June of 2001. But only five percent of women with postpartum psychosis commit suicide and only four percent commit infanticide.

Those numbers could be so much lower, if the general public were aware of the signs and symptoms of postpartum psychosis so that they could intervene before a tragedy could occur. When a woman finds out she is pregnant and begins reading the various pregnancy books out there, there is always a chapter on postpartum depression. I wish those authors would cover the other side of the spectrum too. There are lives at stake.

It happened to me after the birth of our first child in September of 2008. He was a healthy 6 pounds, 12 ounces, delivered via emergency C-section. (He wasn't tolerating the contractions since his heart rate was taking a nosedive with each one, and I wasn't dialating past 5 inches, so the decision was made and at that point I was so exhausted I just couldn't wait for him to be out.) I was absolutely determined to breastfeed him, yet had no clue what I was doing. I just felt all of this outside pressure to make breastfeeding work - all of my friends had breastfeed their children, the books and magazines you read all say that "breast is best" and of course all the literature at the doctor's office was the same. Even the formula company's marketing materials pushed breastfeeding. So of course I put a ton of pressure on myself to make it work. It made those first few days and weeks with baby boy so grueling, draining, and sad. Due to the C-section, and the added stress I was putting on myself to be successful at nursing, my milk took almost a full week to come in. I was breaking out in hives up and down my legs every night because I was so stressed out. Instead of enjoy my baby, I was feeling like I was failing as a mother because I couldn't feed him. The pediatrician had us start supplementing with formula at his 2-day check-up because he had lost too much weight. I was barely sleeping at all. That is how the mania started to spiral me into psychosis.

The days and nights started to mush together as I started to live life in 2-hour increments. The baby would nurse for 45-minutes, then we'd do a diaper change, then he'd nap, but in the hour that he napped I felt as though I had a million things to do so I never napped myself. And it wasn't as if I didn't have help with me. My parents stayed for a week after the baby was born and my husband was off from work for two weeks. So I did have times when I could hand over the baby, but yet, things still had to get done.

It was about seven days after he was born that I remember breaking down in tears in front of my mom with the phone in my hand, outstretched to her, pleading, "Please call my OB and ask her what med I can take that will help me sleep! I can't sleep!"  My mom called and they said I could use Tylenol PM while nursing, and so I did that afternoon and slept four hours straight, the longest stretch of sleep I had gotten since having the baby. The next day my mom changed her flight so that she could stay a few extra days to help out.

I remember feeling as though my mind was starting to race uncontrollably at times during those first four weeks after my son's birth, but somehow I was able to hide it from my husband and my parents. I wanted to be able to breastfeed my son and I knew I couldn't do that while taking medication. So I continued to fight the racing thoughts, but they quickly caught up with me in a big way.

We had our son baptized when he was four weeks and two days old. My parents flew back into town for the ceremony, and stayed with us for that weekend. I drove them and my brother and sister-in-law to the airport on Monday morning. On Tuesday morning I had become manic to the point of psychotic, and had to be hospitalized because I refused to take medication.

I spent a week in a psychiatric facility where the doctors stabilized me using a combination of anti-psychotics, sleep medications, and the mood-stabilizer Lithium. I could not believe that I had missed out on my son's fifth week of life. Completely.

The insomnia was the first and most prominent symptom for me. The delusions and hallucinations are a close second. I refused to eat at times. Each and every sound I hear is amplified one hundred percent. These are the symptoms that I experienced every time I had been hospitalized. Which up until that point had been twice.

The common theme that I experience when I become manic to the point of psychotic is the feeling that the world is ending. Let me tell you - it has got to be the scariest feeling in the world when you are absolutely convinced that it is happening. The time I lost touch with reality after our son was born, I remember that I had been sleeping upstairs since my husband said he would take care of the baby so that I could get some rest. I woke up at some point in the middle of the night and went downstairs to find him asleep on the couch, the gas fireplace blazing, with our son snoozing peacefully on his chest. For a split-second I thought about grabbing my camera to take a picture, but I had no idea where it was or else it seemed like too much of an effort to find it, so I didn't bother. I just woke my husband up and we went upstairs to bed, putting the baby down in the bassinet by our bedside.

A few hours later I couldn't sleep because I kept thinking I heard the baby crying. But he wasn't. My husband kept telling me to go back to sleep. But I couldn't. When he woke up an hour or so later to get ready for work, he knew right away that I wasn't right and he needed to call for help.

(To be continued...)